Why do I need my wisdom teeth removed?
The short answer
Usually because there isn't room for them to come in properly, and that's causing a problem or is likely to. Wisdom teeth that get stuck (impacted) or come in partway can trap bacteria, cause gum infections or decay, and damage the molar next to them.
Common reasons
- Stuck (impacted) teeth that can't come in, often tipped toward the next tooth
- Gum infections around a tooth that's partly through the gum (pericoronitis), especially if they keep coming back
- Decay in the wisdom tooth, or in the back of the molar in front of it
- Gum disease or bone loss around the molar in front
- A cyst or other change around the tooth on an X-ray
- Braces or jaw surgery, when your orthodontist or surgeon asks for them out
If your wisdom teeth don't hurt and you're wondering whether removal is really needed, see My wisdom teeth don't hurt. Do they need to come out?
What “impacted” means on your plan
Removal is billed by how stuck the tooth is, which you'll see as different codes:
- Simple or surgical removal of a tooth that has come in (D7140, D7210)
- Stuck under the gum (D7220)
- Partly stuck in the bone (D7230)
- Fully stuck in the bone (D7240), or with unusual complications (D7241)
The more bone involved, the more involved the surgery, and the higher the fee. Your X-ray should match the level on your plan. If you're curious, ask your dentist to show you.
Your plan's reviewer looks at the same X-ray. If they read the tooth as less stuck than the code says, the plan may pay at a lower level. See tooth removal on the criteria page.
How your dentist decides
Your dentist looks at a panoramic X-ray or a 3D scan to see each tooth's position, how close the roots are to the nerve (lower teeth) or sinus (upper teeth), and the health of the teeth and gums around them. Your age, symptoms, and any past infections matter too.
Who does it
Many general dentists remove wisdom teeth that have come in or are simple. Teeth stuck in the bone, or with roots close to the nerve, are often referred to an oral surgeon, who does this surgery every day and can offer deeper sedation. Being referred is common, not a red flag.
A referral can also make sense if you're nervous about the surgery or would like deeper sedation. If it isn't offered and you'd prefer a specialist, it's fine to ask.
Questions to ask
- Can you show me on the X-ray what you're seeing with each tooth?
- Is there a problem now, or are we preventing one?
- How stuck is each tooth, and is that what's on my plan?
- Are the roots close to the nerve?
- Do all of them need to come out?
- Would you or an oral surgeon do this, and why?
- Before we schedule, can I get my cost in writing? (A predetermination if I'm using insurance, or a good faith estimate if I'm paying myself.)
When a second opinion makes sense
Reasonable if you have no symptoms and no problem is visible on the X-ray, or if you're told all four need to come out and you're unsure why. An oral surgeon is a good choice for a second look.